Provider Demographics
NPI:1619380128
Name:GLESSNER, JESSICA ANNA (NP-C)
Entity Type:Individual
Prefix:MRS
First Name:JESSICA
Middle Name:ANNA
Last Name:GLESSNER
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:MS
Other - First Name:JESSICA
Other - Middle Name:ANNA
Other - Last Name:JADLOCKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:870 E BALTIMORE PIKE
Mailing Address - Street 2:
Mailing Address - City:KENNETT SQUARE
Mailing Address - State:PA
Mailing Address - Zip Code:19348-1842
Mailing Address - Country:US
Mailing Address - Phone:610-500-9732
Mailing Address - Fax:401-652-9787
Practice Address - Street 1:870 E BALTIMORE PIKE
Practice Address - Street 2:
Practice Address - City:KENNETT SQUARE
Practice Address - State:PA
Practice Address - Zip Code:19348-1842
Practice Address - Country:US
Practice Address - Phone:610-500-9732
Practice Address - Fax:401-652-9787
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-03
Last Update Date:2014-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0000733363LF0000X
PASP013921363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily